Search
Close
Search
Advanced Search
Search Menu
AI Discovery Assistant

Extract

In January 2024, a 24-year-old Italian man returned from an 18-day trip to Kenya. Twelve days later, he developed fever and malaise, and was diagnosed with a mixed Plasmodium falciparum and P. malariae malaria, with 5.8% parasitaemia. The patient was hospitalized and treated with three doses of intravenous artesunate, followed by a 3-day course of dihydroartemisinin/piperaquine. At discharge, the patient was asymptomatic and aparasitaemic. However, unsteady gait and dizziness appeared 6 days apart. Upon presentation, he had a wide-based gait with occasional lateropulsions, difficult tandem and closed-eye walking, and slight dysmetria on the finger-to-nose test. Furthermore, he had mild dysarthria. He had no fever, meningeal signs, nystagmus, cranial nerve impairment or sensory deficit. The patient was hospitalized for further diagnostic workup. Brain CT scan and brain and spinal cord MRI with contrast enhancement resulted negative. Laboratory tests on admission showed mild anaemia (127 g/L), negative C-reactive protein and negative malaria hemoscopy. Blood tests for infectious agents causing meningoencephalitis (e.g. enteroviruses, Treponema pallidum, Borrelia) resulted negative. Eventually, a diagnosis of delayed cerebellar ataxia (DCA), a rare post-malaria neurological complication,1 was made. No pharmacological interventions were carried out, and physio-kinesiotherapy was started. The patient was discharged with slight improvement of symptoms after a few days. At a follow-up visit, 4 weeks after discharge, the symptoms had completely cleared up. Figure 1 shows the timeline of events.

Issue Section:
Clinical Pearls
You do not currently have access to this article.
Download all slides